The four points of lethal diamond are coagulopathy, acidosis, hypothermia, and hypocalcemia.

• A. True
• B. False
• C. Hypercalcemia
• D. Hypophosphatemia

Answer: (A)

The key idea is that severe bleeding creates a dangerous combo that sabotages clotting from multiple angles: coagulopathy means the blood can’t clot effectively; acidosis and hypothermia slow the chemical reactions and cellular functions needed for clot formation; and hypocalcemia undermines the calcium-dependent steps of the coagulation cascade and platelet function. Calcium is essential for many points in clot formation, and when levels drop—often from massive transfusion with citrate or dilution—coagulation worsens. Together, these four factors form a dangerous interplay that challenges resuscitation and hemostasis, hence the term lethal diamond. That’s why the statement is true. Hypercalcemia or hypophosphatemia aren’t described as the components of this concept.